This should be made a sticky as most people don’t understand this concept. Many know that it is unwise to take an AI or block estrogen but they don’t know why.
When you get a blood test and measure your testosterone levels, you get a fairly accurate reading as testosterone is transported throughout your body via serum. This much you know.
The part you don’t realize is WHERE it is converted into estradiol (that thing everyone is so afraid of for no reason). That conversion, is done by an enzyme called aromatase. The conversion happens IN the tissue. Once converted, estradiol does NOT get transported around the body in the serum. It remains primarily in the tissue, skeleton, and brain.
When you are measuring serum levels, you are only seeing a TINY FRACTION of the estradiol that is leaking into the serum which doesn’t convey whatsoever the amounts everywhere else in the body. This is like measuring tiny drops of water leaking out of a bucket of water and making claims to how much water is in the bucket. It is absolutely and utterly pointless. This makes estradiol something called a paracrine hormone.
The other part is that every area of the body will have varying levels of estradiol. You can have a lot in one area and very little in another. This is a SELF REGULATING mechanism that the body does naturally. If you take an aromatase inhibitor, you are blocking the conversion of testosterone to estradiol. The problem is that you will have NO IDEA where it will be blocked. It could wind up being blocked just slightly in one area and perhaps blocking all of it in the brain. Taking even the slightest amount of an AI, I don’t care how small, will cause detrimental harm to your health over the course of time.
Symptoms that people claim to be “high E2 issues” are anything but. In the vast majority of cases they are due to hormone fluctuations caused by protocols that are not optimal for that given individual. This is virtually always resolved by ensuring two simple things:
Ensuring that you inject often enough where you are no longer feeling any of the ups and downs during the week. If weekly injections aren’t working, try twice weekly and test over 6-8 weeks. If that doesn’t work try 3 times a week and test. If that doesn’t work you can even try daily (to ensure the most consistent and stable levels we can have). You need to find the frequency that works best for YOU. There is no right answer for this. I can only provide the strategy that works.
Ensure your free testosterone levels are optimal. Don’t even bother with total as that is also a moot point. If you are symptomatic and free T is under 20 you will most likely require more (in the vast majority of cases). Most tend to feel better once they hit 30 (in the vast majority of cases). You MAY be different. You may need less or you may need more. I only report what the majority are doing to eliminate symptoms but this is just a guideline and could wind up being completely irrelevant for your specific case. Don’t target a specific number. Take more or less and determine where YOU feel best, whatever that dose is, until you are free of symptoms.
The video I did with Dr. Jordan Grant is the best example I have so far that explains this completely:
Once you watch it, don’t take his word for it. Read through the studies and medical literature that he provided, as evidence, that demonstrates what he is claiming (as well as what the rest of the doctors I deal with are claiming).
Until you can understand this concept you will never feel your best nor will you have your overall health as your priority.
Again, this is not opinion. Facts demonstrated by evidence.